Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Boston.
J Infect Dis. 2023 Sep 13;228(Suppl 3):S160-S167. doi: 10.1093/infdis/jiad227.
Prior studies demonstrate that eliminating hepatitis C virus (HCV) in the United States (US) heavily depends on treating incarcerated persons. Knowing the scope of the carceral HCV epidemic by state will help guide national elimination efforts.
Between 2019 and 2023, all state prison systems received surveys requesting data on hepatitis C antibody and viremic prevalence. We supplemented survey information with publicly available HCV data to corroborate responses and fill in data gaps.
Weighting HCV prevalence by state prison population size, we estimate that 15.2% of the US prison population is HCV seropositive and 8.7% is viremic; 54.9% of seropositive persons have detectable RNA. Applying prevalence estimates to the total prison population at year-end 2021, 91 090 persons with HCV infection resided in a state prison.
With updated and more complete HCV data from all 50 states, HCV prevalence in state prisons is nearly 9-fold higher than the US general population. The heterogeneity in HCV prevalence by state prison system may reflect variable exposure before arrest and/or differences in treatment availability during incarceration. Elimination of HCV in the country depends on addressing the carceral epidemic, and one of the first steps is understanding the size of the problem.
先前的研究表明，在美国消除丙型肝炎病毒 (HCV) 主要依赖于治疗被监禁的人。了解各州监狱 HCV 流行的范围将有助于指导国家消除努力。
在 2019 年至 2023 年期间，所有州立监狱系统都收到了要求提供丙型肝炎抗体和病毒血症流行率数据的调查。我们利用公开提供的 HCV 数据补充了调查信息，以证实答复并填补数据空白。
根据州立监狱人口规模对 HCV 流行率进行加权，我们估计美国监狱人口中有 15.2%的人 HCV 血清阳性，8.7%的人病毒血症阳性；54.9%的血清阳性者有可检测到的 RNA。将流行率估计应用于 2021 年底的总监狱人口，有 91090 名丙型肝炎病毒感染者居住在州立监狱。
有了来自所有 50 个州的更新和更完整的 HCV 数据，州立监狱中的 HCV 流行率几乎是美国普通人群的 9 倍。各州监狱系统中 HCV 流行率的异质性可能反映了被捕前的不同暴露情况，或在监禁期间治疗的可获得性存在差异。要在全国范围内消除 HCV，就必须解决监狱中的 HCV 流行问题，而第一步就是了解问题的严重程度。
